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Women, Children Hardest Hit by Ethiopia's Deepening AIDS Crisis

One out of every 11 people in the world infected with HIV is Ethiopian. And the crisis appears to be deepening, especially in urban centers like Addis Ababa, Ethiopia's capital, despite recent government efforts to educate its population and to provide wider access to free antiretroviral drugs to halt the spread of AIDS.

This is Radeat Behonegn. Her song is about a girl who wakes up one morning to find a bird has flown away with her heart. The girl in the song says her body is healthy, but she misses her heart and asks the bird to return it.

It's a common children's song in Ethiopia, but for Radeat the words have deep and probably unrealized emotional resonance. She is six years old and was orphaned two years ago after her parents died of AIDS-related illnesses.

Radeat, like the girl in the song, is healthy, the virus that eventually killed her mother and father passed over her. Still, she misses her parents. She used to spend hours at the window of the orphanage, waiting for them to return.

But she's not alone. In Ethiopia, the government says nearly 500,000 children have been orphaned by AIDS. About a third of them are infected with the virus through mother-to-child transmissions, according to government health officials. In Ethiopia, 70 babies are born with the HIV virus every day.

It's part of the country's worsening AIDS crisis that kills more than 300 people every day. While government health officials say about 1.5 million of Ethiopia's 70 million people are infected with HIV, the World Health Organization puts the figure at nearly double that. And particularly worrying to United Nations agencies dealing with AIDS and Ethiopia's cash-strapped health ministry is that in the past few years the HIV infection rate in urban areas like Addis Ababa has climbed to about 13-percent.

Addis Tamrat is on the front lines of Ethiopia's AIDS crisis. She is acting director of Hope for Children, a nongovernmental agency supported by UNICEF, the U.N. agency for children, which accepts private donations to provide housing and medical care for more than 400 children orphaned by AIDS.

Ms. Tamrat often deals with mothers in the final stages of AIDS. Without hope of getting life-prolonging antiretroviral drugs, or ARVs, the mothers plead with her to take care of their children. Hope for Children already has a waiting list of about 150 orphans.

"There is a big need. As you see, there are a lot of organizations working on HIV and AIDS," Ms. Tamrat says. "But it's difficult for them to bring the ARV drugs because it's so expensive. Ethiopians needs great support, great help from foreigners just to get the ARV drugs. Most of the HIV-positive are neglected."

To fight the AIDS scourge, Ethiopia last month launched a massive government program to provide free anti-retroviral drugs to about 30,000 Ethiopians by the end of this year. The $43 million program, funded largely by the United States, intends to reach more than 200,000 patients within the next three years.

But the new initiative comes too late for Belaynesh Beyene, a 23-year-old mother of two who, Ms. Tamrat says, is only days away from death. AIDS has eaten her body down to bones, bringing to mind images of Ethiopians emaciated by the famines of the 1980s. Breathing, for her, is a struggle. Talking is even harder.

Her husband abandoned her after she tested positive for HIV while pregnant with their first child. She says that, up to then, he was the only man she's ever had sex with, and most likely she contracted the virus from him. It's a too-common theme in Ethiopia's AIDS fight: women are unable to protect themselves from philandering husbands, or husbands who take multiple wives. In Ethiopia, marriage is a risk factor for AIDS.

After her husband left her, she met another man with whom she had another child. But Belaynesh says she was forced to hide her HIV-positive status from him, because she needed him to help provide food for her and her children. But he eventually saw the signs, the frequent sicknesses, the sudden weight loss, and, like her husband, abandoned her.

Now, Belaynesh tries to keep her illness hidden from her own daughters, aged five and three. She speaks through a translator.

"I am worried that if I die, there is no one responsible to take care of them. That's what makes me worried. … I don't talk with them [about AIDS], because after I die, it will make them more distrustful. It makes them more depressed. And I don't speak such kinds of things with my children."

Belaynesh says she also wants to protect her daughters from the shame of having their playmates and neighbors know their mother has AIDS. Such is the stigma of the disease in Ethiopian society. People with AIDS often are shunned by their own families and ostracized by their neighbors. In Ethiopia, people with AIDS more often than not, die in solitude.

Later in the interview, it surfaces that Belaynesh has held something else back from her daughters: they are both HIV-positive.

But at least they can hope to be counted among the hundreds of thousands of Ethiopians slated to receive free ARVs in the next three years. For them, having the virus isn't necessarily a death sentence.